• Articles

    Care of the College Student

    Brian K. Unwin, Jeffrey Goodie, Brian V. Reamy, Jeffrey D. Quinlan

    Although generally healthy, about 20% of students who attend college have special health care needs, including asthma, diabetes mellitus, and learning, mental health, and substance use disorders. Physicians can facilitate the transition of a youth to an adult model of health...

    Human Papillomavirus: Screening, Testing, and Prevention

    Jeffrey D. Quinlan

    There are more than 200 types of human papillomavirus (HPV). HPV infection can be latent and subclinical, or have a presentation ranging from benign cutaneous and mucosal lesions to life-threatening clinical carcinomas. Screening for HPV infection effectively identifies...

    Dysmenorrhea

    Kathryn A. McKenna, Corey D. Fogleman

    Dysmenorrhea is common and usually independent of pelvic pathology. Secondary dysmenorrhea may present with progressive worsening of pain, abnormal uterine bleeding, or dyspareunia. Nonsteroidal anti-inflammatory drugs and hormonal contraceptives are first-line medical...

    Breast Cancer Treatment

    Kathryn P. Trayes, Sarah E.H. Cokenakes

    Breast cancer is the leading cause of cancer deaths in women worldwide and the second most common cause of death from cancer in women in the United States. Primary care physicians are often the first point of contact for patients with a new diagnosis of breast cancer.

    Sinus Node Dysfunction

    Matthew Kendall Hawks, Madison L.B. Paul, Omojo Odihi Malu

    Sinus node dysfunction describes disorders related to abnormal conduction and propagation of electrical impulses at the sinoatrial node that interfere with pacemaker function. A diagnosis is made by directly correlating symptoms with a brady-arrhythmia and eliminating...

    Pertussis: Common Questions and Answers

    Jonathan M. Kline, Eleanor A. Smith, Adrienne Zavala

    The presentation of pertussis, or whooping cough, is variable and evolves over the course of illness, which often includes a catarrhal, paroxysmal, and convalescent stage. Diagnosis should be confirmed using polymerase chain reaction testing. Immunity typically wanes two to...

    Editorials

    Fallacies and Dangers of Practicing Race-Based Medicine

    Bonzo Reddick

    Race does not have a biologic definition, but rather a political and social one that is fluid and independent of science. Nevertheless, the medical community uses race as a scientific variable in several prominent clinical situations, including calculation of atherosclerotic...

    Graham Center Policy One-Pagers Provide Perspectives on the State of Primary Care

    Kenneth W. Lin, Yalda Jabbarpour, John M. Westfall

    Previous Graham Center Policy One-Pagers published in AFP have provided timely perspectives on a range of topics. In 2020, the Graham Center, in collaboration with IBM Watson Health and the American Board of Family Medicine, produced a chartbook of statistics on the current...

    Graham Center Policy One-Pagers

    State-Level Variation in Primary Care Physician Density

    Karissa Merritt, Yalda Jabbarpour, Stephen Petterson, John M. Westfall

    Despite representing only one-third of the physician workforce in the United States, primary care physicians (PCPs) are the first contact with the health care system for most patients. A 2010 report by the Council on Graduate Medical Education recommended that 40% of the...

    Medicine by the Numbers

    Accuracy of Ultrasonography for the Diagnosis of Small Bowel Obstruction

    Brit Long, Michael Gottlieb

    According to a meta-analysis including prospective observational studies evaluating the accuracy of ultrasonography for the diagnosis of small bowel obstruction, ultrasonography appears to be highly sensitive and specific for this use.

    AFP Clinical Answers

    Prenatal Vitamins, Patellofemoral Pain Syndrome, Alcohol Misuse, Hernia, Anaphylaxis, Gout

    Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

    Cochrane for Clinicians

    Levonorgestrel-Releasing Intrauterine System for Reducing Heavy Menstrual Bleeding

    Michael Loeven, Emily Brown

    The levonorgestrel-releasing intrauterine system is more effective than other medical therapies at reducing menstrual bleeding volume, with similar rates of adverse effects. The effectiveness of the levonorgestrel-releasing intrauterine system compared with endometrial...

    Can Pioglitazone Prevent or Delay Type 2 Diabetes in Patients with Prediabetes?

    Pamela O. Obi

    Pioglitazone prevents or delays the incidence of type 2 diabetes in individuals with prediabetes when compared with placebo (absolute risk reduction [ARR] = 11.3%; 95% CI, 0.9% to 15.6%; number needed to treat [NNT] = 9) or no intervention (ARR = 13.3%; 95% CI, 11.6% to 14.9%...

    Putting Prevention Into Practice

    Screening for Hypertension in Adults

    Tina Fan, Marissa Tan

    A 23-year-old patient, M.C., comes to your office for a wellness visit with no concerns. On reviewing the patient's medical record, you note that M.C. has a history of polycystic ovary syndrome, blood pressure of 110/70 mm Hg from a visit one year ago, and a body mass index...

    Implementing AHRQ Effective Health Care Reviews

    Diagnosis and Initial Management of Acute Colonic Diverticulitis

    Jacqueline DuBose, Dean Seehusen

    What are the benefits and harms of diagnostic testing, and what is the effectiveness of treatment options for acute colonic diverticulitis?

    Diary of a Family Physician

    Diary of a Family Physician

    Sarah Cheek, Alexandra Schieber

    First-person accounts from the front lines of family medicine.

    Photo Quiz

    Red, Raised Papule on the Chest

    Julia Carroll, Natalie DiMaio

    A patient presented with a red, slightly raised papule on the anterior chest wall.

    Acute Sharp Flank Pain

    Phillip Kim, Alvin Vong

    A patient presented with stiffness and pain in his lower back and both thighs and an abnormal CT scan.

    FPIN's Help Desk Answers

    Hydrochlorothiazide vs. Chlorthalidone for the Treatment of Hypertension

    Jason M. Barnes, Wendra J. Galfand

    Chlorthalidone reduces systolic blood pressure by 10 mm Hg more than hydrochlorothiazide at equal dosages in patients using monotherapy. Low-dose chlorthalidone and controlled-release hydrochlorothiazide reduce 24-hour ambulatory systolic blood pressure and diastolic blood...

    FPIN's Clinical Inquiries

    Physical Activity and the Prevention of Depression

    Corey Lyon, Allison Johnson, Kristen DeSanto

    Physical activity appears to be associated with a lower risk of developing depression and depressive symptoms.

    POEMs

    SGLT2 Inhibitors or GLP-1 Receptor Agonists Reduce Cardiovascular Outcomes in Patients with Type 2 Diabetes

    Allen F. Shaughnessy

    SGLT2 inhibitors, the diabetes medications ending in -flozin, and GLP-1 receptor agonists, the -tide medications, decrease cardiovascular and renal outcomes to a greater extent than placebo or other treatments. They should be considered in addition to metformin and other...

    More than One-Half of Adults Hospitalized for COVID-19 Still Report Significant Symptoms at Four Months Postdischarge

    Henry C. Barry

    This study found that more than one-half of the adults (51%) who had been hospitalized for COVID-19 reported a significant amount of persistent symptoms four months after discharge.

    Inhaled Budesonide Reduces the Risk of Emergency Department Evaluation or Hospitalization in Early COVID-19

    Mark H. Ebell

    Inhaled budesonide, 800 mcg twice daily, significantly reduces the likelihood that patients with early COVID-19 will require emergency department evaluation or hospitalization (number needed to treat = 7 to 8). This is a widely available, relatively inexpensive drug with the...

    Tighter Blood Pressure Control Does Not Increase the Likelihood of Orthostatic Hypotension

    Allen F. Shaughnessy

    Orthostatic hypotension, a drop of 20 mm Hg systolic or 10 mm Hg diastolic after moving from sitting to standing, was not associated with more intensive treatment of blood pressure and may be less likely to occur with intensive treatment.

    Practice Guidelines

    Management of Gout: Update from the American College of Rheumatology

    MaryAnn Dakkak, Howard Lanney

    The American College of Rheumatology published updated guidelines for gout management focused on improving prevention of flare-ups.

    Iron Deficiency Anemia: Guidelines from the American Gastroenterological Association

    Kento Sonoda

    The American Gastroenterological Association developed guidelines for the evaluation of IDA in adults.

    Letters to the Editor

    Automated Office Blood Pressure for Diagnosing Hypertension

    Lenard I. Lesser

    Community Alcoholics Anonymous Programs Are Not a Replacement for Formal Treatment

    Strangulation as a Cause of Dysphagia

    Case Report: Consequences of Misdiagnosed Anal Cancer

    Anuja Trivedi, Ruksana Nazneen

    Information from Your Family Doctor

    Painful Menstrual Periods

    Many people have some crampy pain with their periods, especially as teenagers. The pain often is low in the pelvis and starts just before your period or at the beginning of your period. It often lasts one to three days. The pain can be bad enough to keep you from doing things...



    Disclosure

    All editors in a position to control content for this activity, AFP journal, are required to disclose any relevant financial relationships. View disclosures.


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